The power of regret

Painful recollections can become a positive force for change, therapists say.

Regret is as old as conscience itself, a staple of Bible stories and barroom confessions through the ages. Yet only recently have researchers begun to clarify its emotional impact, and learn how it affects our health and behavior.

"Especially after middle age, regret can become a very powerful factor in the way people think about themselves," said Dr. William Callahan, an Irvine psychiatrist. "I hear it all the time: 'I never got close to my children' or 'I promised myself I'd never be the reincarnation of my father, and I've become him.' "

They are the kind of laments, therapists say, that can turn us against ourselves for the rest of our lives.

Yet the common response -- to look away, to move on -- is neither psychologically healthy nor realistic, some psychological researchers say. Regrets can be emotional billboards, announcing who we are and what we most want. By changing the way we think about regrets, we can even alter their emotional impact. This evolving view is based partly on research, partly on the experience of psychiatrists caring for older adults. For these therapists, patients' regrets are not necessarily a sinkhole of misery but a reservoir of personal history that can be used to relieve symptoms of depression and anxiety, especially in older adults.

Regret, said Dr. Daniel Plotkin, a geriatric psychiatrist in Los Angeles, "is a natural part of having lived a full and rich life," often reflecting a history of many dilemmas and complex choices.

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Learning from the past

Regrets are one form of the endless loop of what-might-have-beens that braids itself into the ongoing life narrative that runs in our heads, psychological researchers say. Some of these thoughts are benign and directly useful: The observation "I should have studied harder for that last test" can motivate people to work hard and score better the next time, research has shown.

It is the larger self-betrayals that permanently crimp our narrative tape: a marriage ended too soon, or too late; an educational degree left unfinished; a move across the country, away from aging parents. "Imagining what might have been is usually healthy; it's one way we learn from the past," said Neal Roese, an associate professor of psychology at the University of Illinois in Urbana-Champaign who studies how thoughts like regret influence behavior. "But there's a big difference when something awful happens and we cannot repair it. That's when we can get stuck in the negative emotions of serious regret."

In some severely depressed patients, these memories can be overwhelming, and are best left alone, experts say. Probing regrets may only deepen their despair, and could prompt suicidal thoughts, said Dr. Joel Streim, a geriatric psychiatrist at the University of Pennsylvania.

But many people swimming in self-blame are likely making themselves ill. Preliminary evidence from an ongoing study of 120 older men and women suggests that serious regrets are associated with physical symptoms, such as migraine headaches and gastrointestinal problems, according to Carsten Wrosch, a researcher at Concordia University in Montreal.

In a study published this June, Wrosch and Jutta Heckhausen, a psychologist at UC Irvine, reported that the specific way we think about our regrets can significantly affect our emotional well-being. The healthiest approach varies with age, they found. The pair administered questionnaires on regret and mental health to 122 adults ranging in age from 20 to 87. Younger adults who scored high on measures of mental health tended to blame themselves for the behavior they regretted; they assumed they had full control of the situation. This makes sense, the researchers conclude: When we're young, we still have plenty of opportunity to repair damage we've done, and regrets can motivate us to do so.

In contrast, older adults scoring high on the tests were more likely to give themselves a break. With little or no ability to take action to remedy the consequences of their mistakes, they apparently adapted by altering their perception of the regret; they no longer shouldered all the blame. If an estranged father had died before they could repair the relationship, for instance, these people told themselves, "I tried, but Dad never gave an effort"; or that Dad's second wife "never wanted us to be close," according to Wrosch. Spreading blame in this way defanged the memory and allowed them to think about their father without needless self-loathing.